<div class="row-fluid">
  <h3><?php echo $page ?></h3>
</div>

<div class="row-fluid">
  <div class="span7">
    <p><?php echo $info ?></p>

    <form class="form-contact form-horizontal" method="post">
      <!-- Nome -->
      <div class="control-group">
        <label for="name" class="control-label">Nome</label>
        <div class="controls">
          <input id="name" class="input-block-level" name="nome" type="text" />
        </div>
      </div>

      <!-- E-mail -->
      <div class="control-group">
        <label for="email" class="control-label">E-mail</label>
        <div class="controls">
          <input id="email" class="input-block-level" name="e-mail" type="email" />
        </div>
      </div>

      <!-- Mensagem -->
      <div class="control-group">
        <label for="message" class="control-label">Mensagem</label>
        <div class="controls">
          <textarea id="message" class="input-block-level" name="mensagem" rows="5"></textarea>
        </div>
      </div>

      <!-- Form actions -->
      <div class="action-group text-right">
        <i class="loading hide"></i>
        <button id="enviar" class="btn btn-inverse btn-large pull-right" type="submit">Enviar</button>
      </div>
    </form>
  </div>

  <div class="span5 stripes">
    <h4>(14) 3261-7147</h4>
    <h4>(11) 95558-6959</h4>

    <address>
      Rua XV de Novembro 595 e 665 &nbsp; | &nbsp; Centro<br />
      CEP 17120-000 &nbsp; | &nbsp; Agudos &nbsp; | &nbsp; SP<br />
      <br />
      <a href="//goo.gl/maps/OgnFD">Veja nosso endereço no Google Maps</a>
    </address>

    <div id="map_canvas_contato"></div>
  </div>
</div>